Mar 25, 2020

World Health Organization Coronavirus Briefing Transcript March 25: Praises US Leaders on Response

World Health Organization Briefing Coronavirus Transcript March 25
RevBlogTranscriptsPress Conference TranscriptsWorld Health Organization Coronavirus Briefing Transcript March 25: Praises US Leaders on Response

The World Health Organization (WHO) held a March 25 press conference with COVID-19 updates. WHO officials praise US leaders on coronavirus pandemic response. Read the full transcript of the press conference.

Margaret: (01:18)
Good morning, good evening and good afternoon. Hello and welcome everybody to the World Health Organization press briefing on COVID-19. We have with us as always, the WHO Director General Dr. Tedros, also Dr. Mike Ryan, Executive Director of our emergencies program and Dr. Maria Van kickoff, Technical Lead for COVID-19. Dr Tedros will begin with an update and then when Dr. Tedros has finished his opening remarks, I will open the meeting to questions. If you’ve connected via zoom, please use the raise your hand icon to get into the queue to ask your question. If you’ve connected by phone, please hit hash nine on your keypad to indicate that you want to ask a question. I’m going to apologize right now to all those who miss out. We have more than 260 people on the line already connecting and asking questions, so we have to restrict this briefing to an hour so that our speakers who are all leading the response can get back to the many other demands on their time. I will now hand over to Dr. Tedros.

Dr. Tedros Adhanom: (02:26)
Thank you, Margaret. Good morning, good afternoon and good evening wherever you are. The pandemic continues to take a massive toll, not just on health but on so many parts of life. Yesterday the government of Japan and the international Olympic committee took a difficult but wise decision to postpone this year’s Olympic and Paralympic games. I thank Prime Minister Abe and the members of the IOC for making the sacrifice to protect the health of athletes, spectators and officials. We look forward to next year’s Olympics and para Olympics, which we hope will be an even bigger and better celebration of our shared humanity and look forward to join.

Dr. Tedros Adhanom: (03:23)
We have overcome many pandemics and crisis before. We will overcome this one too. The question is, how large a price we will pay. Already we have lost more than 16,000 lives. We know we will lose more. How many more will be determined by the decisions we make and the actions we take now. To slow the spread of COVID-19, many countries have contributed or introduced unprecedented measures at significant social and economy costs, closing schools and businesses, canceling sporting events and asking people to stay home and to stay safe.

Dr. Tedros Adhanom: (04:23)
We understand that these countries are now trying to assess when and how they will be able to ease this measures? The answer depends on what countries do while this population wide measures are in place. Asking people to stay at home and shutting down population movement is buying time and reducing the pressure on health systems, but on their own, these measures will not extinguish epidemics. The point of these actions is to enable the more precise and targeted measures that are needed to stop transmission and save lives. We call on all countries who have introduced so-called [inaudible 00:05:19] to use [inaudible 00:05:21] to attack the virus. You have crated a second window of opportunity. The question is, how will you use it? There are six key actions that we recommend. First, expand, train and deploy your healthcare and public health workforce, and second, implement a system to find every suspected case at community level. Third, ramp up production, capacity and availability of testing. Fourth, identify, adapt and keep facilities you will use to treat and isolate patients. Fifth, develop a clear plan and process to quarantine contacts. And finally, number six, refocus the whole of government on suppressing and controlling COVID-19. These measures are the best way to suppress and stop transmission so that when restrictions are lifted, the virus doesn’t re-surge. The last thing any country needs is to open schools and businesses only to be forced to close them again because of a resurgence. Aggressive measures to find, isolate, tests, treat, and trace, are not only the best and fastest way out of extreme social and economic restrictions, they are also the best way to prevent them.

Dr. Tedros Adhanom: (07:15)
More than 150 countries and territory still have fewer than 100 cases. By taking the same aggressive actions now, these countries have the chance to prevent community transmission and avoid some of the more severe social and economy costs to seen in other countries. This is especially relevant for many vulnerable countries whose health systems may collapse under the weight of the numbers of patients we have seen in some countries with community transmission. Today, I joined the United nations Secretary General Antonio Gutierrez under Secretary General for UN Mark Lowcock, and UNICEF, Executive Director, Henrietta Fore, to launch the global humanitarian appeal to support the most fragile countries who have already suffered years of acute humanitarian crisis. This is much more than health crisis and we’re committed to working as one UN to protect the world’s most vulnerable people from the virus and its consequences.

Dr. Tedros Adhanom: (08:34)
About vulnerable countries, all countries have vulnerable populations, including older people. Older people carry the collective wisdom of our societies. They’re valued and valuable members of our families and communities, but they’re at higher risk of the more serious complications of COVID-19. We’re listening to all their people and those who work with and for them, to identify how best we can support them. We need to work together to protect older people from the virus and to ensure their needs are being met for food, fuel, prescription medication, and human interaction. Physical distance doesn’t mean social distance. We all need to check in regularly on older parents, neighbors, friends or relatives who live alone or in care homes in whatever ways possible, so they know how much they’re loved and valued. All of these things are important at any time, but they’re even more important during a crisis.

Dr. Tedros Adhanom: (10:03)
Finally, the COVID-19 pandemic has highlighted the need for compelling and creative communications about public health. Last year, WHO announced our first health for all film festival. The volume, quality, and diversity of entries far surpassed our expectations. We received more than 1,300 entries from 110 countries, and today we’re announcing a short list of 45 excellent short films about vital health topics. We’re also announcing a distinguished panel of jurors who will judge the shortlist, with the winners to be announced in May. We will be showing all the shortlisted films in the coming weeks on our website and social media channels. In these difficult times, films and other media are a powerful way not only of communicating important health messages, but of administering one of the most powerful medicines, hope. I thank you.

Margaret: (11:25)
Thank you Dr. Tedros. We’ll now open the floor to questions. As I mentioned before, a little housekeeping. If you’ve connected by a zoom, please use the raise your hand icon to get in the queue. If you’ve connected via phone, please hit hash nine on your keypad. Please restrict your questions to one question. Please try to keep them as short as possible because there are so many people who need to ask their question. In fact, we had so many questions left over from Monday. I’m now going to read a question from Simon Ateva because he has been waiting I think three times to ask this question. I cannot see him in the queue. Read it out for you, Simon. Simon, I hope if you’re there on Twitter you can hear this question. So this is from Simon Ateva from Today News Africa. Simon asks Dr. Tedros, the coronavirus pandemic is fast spreading across Africa and is threatening to overwhelm our weak healthcare system. The Center For Global Development in Washington DC is warning that if developed countries do not support Africa today, this pandemic will not be defeated. What type of concrete assistance can WHO drive to assist Africa now before it’s too late?

Michael J. Ryan: (12:52)
I can begin and I’m sure Dr. Tedros will supplement. WHO has country officers in every country in Africa and our country representatives and the teams there have been supporting countries for many, many years. In addition to that, our Regional Director, Dr. [inaudible 00:13:11] has surged many, many staff from the regional office and teams to support countries and allow better support to be provided in planning. We’ve supported the process of national action planning, sent PPE, sent and dispatched lab test. We’ve worked with the Africa CDC to train lab technicians from all over Africa, and we’re currently working on increasing all of the capacities in surveillance, in clinical management and trying to work to provide more support in terms of supply chains.

Michael J. Ryan: (13:41)
It’s a challenging situation for all countries in Africa and the international community I think, and for all countries of the South and low and middle income countries need support. And the North must while dealing with a massive crisis in its own regard, must move to protect the South because nobody is safe until we are all safe.

Dr. Tedros Adhanom: (14:10)
Thank you so much. Thank you Mike. The number of cases in sub Saharan Africa is around 1,600 as we speak. And if you take the number of cases, this is actually an opportunity to use the sixth recommendations I just made, meaning to be able to cut it from the bud. They can test, they can isolate, quarantine cases while still the number of cases is low.

Dr. Tedros Adhanom: (14:46)
So the first thing is they should believe that this thing is in their hands. They can do something to stop it as early as possible. But then of course we have global responsibility as humanity and especially those countries like the G 20, we will have the G 20 summit tomorrow. They should be able to support countries all over the world, not only from Subsaharan Africa, but all over the world who are low income or middle income countries, because it’s only through solidarity that we can support those countries.

Dr. Tedros Adhanom: (15:34)
From WHO’s side, we have started as early as possible to support countries by providing test kits and we have provided already test kits to more than 120 countries and a good number of them are from the African continent and also PPE to 68 countries and most of these countries are from Africa, and WHO will continue to support countries who need our support and we are negotiating with many stakeholders to build up our especially logistics capacity to continue to supporting countries as we have been doing.

Margaret: (16:25)
Thank you Dr. Tedros. The next questions from Jamil, from Brazil, somebody else who’s also had been waiting to ask his question for about a week. Please go ahead. Jamil.

Jamil: (16:36)
Yes, Mr. Tedros, this is Jamil from UOL and [inaudible 00:16:41]. My question is again on President Bolsonaro and apologize for even insisting on this, but his remarks last night and over the last days, are they actually putting the lives of Brazilians at risk and would you ask him to change his position and take responsibility? Thank you so much sir.

Michael J. Ryan: (17:08)
I think we’ve spoken on this issue and issues like this before. We trust that all governments will take the appropriate actions to manage the public health risks here which are real, but we also understand the terrible dilemmas that countries face in protecting economies and social systems. We must focus first on trying to stop this disease and saving lives.

Dr. Tedros Adhanom: (17:42)
It may be just repeating what I said, but our advice to all countries is, of course, many countries are already taking community wide actions, closing schools, restricting movement, and asking citizens to stay at home and all possibilities to have physical distancing. That’s very important, but at the same time, we have proposed six actions, and that will also apply to any country, and that’s what we said. There are countries, 150 countries with less than a hundred cases. They have to be very serious actually at this stage when they have less number of cases. And the first thing they should do is, they should expand, train and deploy their health workers, healthcare and also public health workforce. And they should implement a system wide approach to.

Dr. Tedros Adhanom: (19:03)
… the system wide approach to find suspected cases at community level. And this is for all countries, even countries with no cases. We have some countries who have not reported cases. And we even suggested that countries should actually ramp up production and capacity and availability to do more testing. And the first recommendation we made is identify, adapt and keep facilities. We have to prepare actually the facilities for any eventualities.

Dr. Tedros Adhanom: (19:38)
In some countries the number of cases have really jumped and overwhelmed the system and they were not prepared. So it was very difficult to give service to patients who were coming to the hospitals to get service. So preparing the system is very important for any country, including those countries who haven’t reported cases or countries who have reported less than 10 cases, or countries who have reported less than 100 cases, or more than 100 cases, or 1,000 cases.

Dr. Tedros Adhanom: (20:17)
And confirmed cases should also be isolated. And this is the same recommendation for every country. And the other very important recommendation we have made is, we need to have a whole of government approach because this pandemic cannot be arrested by just the health sector alone. We need to have all relevant sectors working together to suppress and control this pandemic. And not only the whole government approach, we are also saying we need the trust of the community. And communities should be mobilized to do their share, because this is everybody’s business, and every citizen has a responsibility to take part. So these are our recommendations, which we believe apply to all countries.

Dr. Tedros Adhanom: (21:18)
This virus is very dangerous and we have already counted more than 16,000 deaths. If you remember, we have been saying for more than two months now, this virus is public enemy number one. It’s a dangerous virus. And we have been saying to the world that the window of opportunity is narrowing and the time to act was actually more than a month ago, two months ago. That’s what we have been saying.

Dr. Tedros Adhanom: (21:52)
But we still believe that there is opportunity. I think we squandered the first window of opportunity. But, we are saying today, my message, I made it clear that this is a second opportunity, which we should not squander. And do everything to suppress and control this virus. And this is a responsibility for all of us, especially the political leadership is key. And it has to be able to mobilize communities. Also, to take ownership and do the right things to suppress and control this pandemic.

Margaret: (22:40)
Thank you very much, Dr. Tedros. Now, we’ll move to Italy. We have Duilio Giammaria from RAI Italian Public TV. Duilio, are you there? Duilio can you hear us?

Duilio Giammaria: (22:59)
Yes.

Margaret: (22:59)
You are there. Please, go ahead.

Duilio Giammaria: (23:01)
Yes, I’m here.

Margaret: (23:06)
That’s bad feedback. Duilio, try and say your question again. If not, I’ll read it out because I do have some text on your question. It sounds like we can’t hear. I’ll read out your questions, Duilio. Duilio wanted to know what WHO thinks about testing and active surveillance in Italy at this stage. What should Italy be doing in terms of testing and active surveillance?

Michael J. Ryan: (23:38)
I think our Italian colleagues, and we actually spoke with our Italian colleagues today and we have a very senior member of our staff currently embedded in Italy and providing high level inputs and advice. And our Regional Director, Hans Kluger, is also in constant contact with the Ministry of Health. Italy is breaking down its problem. It’s looked at each and every single one of its provinces and trying to look at those provinces in terms of where they are. I think many of you will have seen Tony Fauci and others speak about this in the US. We need to start looking at the data. We need to start breaking the problem down. You can’t look at a whole country as one entity. You break the problem down. You look at your local geographies, you see what the situation is in each and every administrative level and then you decide what the best tactics are.

Michael J. Ryan: (24:29)
There are some parts of Italy where transmission is very intense and it’s very difficult to get a handle on testing all cases, on doing contact tracing. There’s a real attempt to save life at this point. And the lockdown measures are there in order to try and suppress infection, but there are parts of Italy in which transmission is not that intense, and where there’s a real possibility of avoiding the worst that has happened in many of the parts of Northern Italy.

Michael J. Ryan: (24:56)
So I that our Italian colleagues are trying to scale up as the Director General has just said, train the workforce, train public health workers, get out and do community detection to detect suspect cases, to isolate suspect cases, to trace contacts. But, we fully understand that in certain areas, right in the center epicenters, it is difficult to do that when you’re dealing with a heavy wave and dealing with the health system under huge pressure.

Michael J. Ryan: (25:27)
So we really do admire our colleagues in Italy. They’re heroes, they’re putting up a courageous fight against this virus on behalf of their own people and behalf of the world. And we like and support the way they’re breaking the problem down. They’re working their way through the problem and we will do everything in our power in the World Health Organization to support them and their efforts.

Dr. Maria Van Kerkhove: (25:54)
Thanks. If I could just supplement what Mike has said. Beyond Italy, I think there are many, many countries that are looking at the situation that they’re in, the transmission situation that they’re in, and the situation seems completely overwhelming. And that testing with us saying test and how important that is as part of this comprehensive package is a fundamental aspect that needs to be enhanced. And we hear you. We are on the phone with our colleagues every day who say to us, “This seems impossible. This is not something that we can do. What should we do?” We’ve been very clear that it’s critical that you test to find where this virus is so you know where you’re fighting it. To find all of your suspect cases, test those suspect cases, find those contacts, test those contacts who develop symptoms and by doing so you are able to actually break down those chains of transmission.

Dr. Maria Van Kerkhove: (26:50)
But when the situation is such that you have community-wide transmission and there are some areas of very large outbreaks, there’s ways in which you may need to prioritize some of those actions so that you could break down the problem, like Mike has just said. Find those boundaries of where that big outbreak is so that you could bring it more under control. And in taking those temporary, making those tough decisions temporarily will help you bring you back to being able to actually find all those suspect cases.

Dr. Maria Van Kerkhove: (27:17)
As the Director General has said, these so-called lockdown measures that many countries have implemented, and more and more we’re hearing about countries implementing these so-called lockdown measures. This is buying you a little bit of time and that time needs to be used appropriately. And that time must be used to build up again your workforces to be able to find those cases, to be able to break down a much larger problem into something that becomes more manageable.

Dr. Maria Van Kerkhove: (27:46)
We have guidance that we have on our website, which works through with you, with all countries, which transmission scenario you may be in, outlines some of the considerations that you may need to take if you’re in clusters, large clusters of cases or if you’re in community transmission, with the overall aim of bringing you back from community level transmission to clusterings of cases down to individual chains of transmission, so that that transmission can be suppressed and you can bring those outbreaks under control. We hear you, we understand that this is overwhelming in many cases, but there are things that you can do to suppress and slow transmission and save lives.

Dr. Tedros Adhanom: (28:31)
Just two lines. The commitment of the Italian government is really, really incredible. And we can see on the ground how it’s moving now. And not only that, the cooperation from the citizens of the country, from Italy, is also amazing. And I think this will bring result and that’s what WHO believes. And as Mike said, we will do everything to support. And there are some good signals now. We had a discussion with some of the senior experts from Italy today and we hope this positive signal in progress will continue, but I am really happy to see that Italy is doing all it can.

Margaret: (29:32)
Thank you, Dr. Tedros. The next question’s from Catherine [inaudible 00:10:36]. Sorry, Catherine. Catherine, can you hear me?

Catherine: (29:42)
Yes, do you hear me?

Margaret: (29:44)
Yes, please go ahead.

Catherine: (29:46)
Okay. Good afternoon, Dr. Tedros, Mike and Maria. My question is relating the testing. As people and most of the countries are saying that conventional equipment is not available, does WHO advise them to turn to tech as an innovation as South Korea is doing by using interactive websites, apps that permits a self-diagnosis, backtrack movements of infected persons? And for that, are you actively collaborating with ITU? If it’s the case, could you please elaborate a bit on that? Thank you.

Michael J. Ryan: (30:36)
Yes. I would say this is probably the first epidemic of a pandemic of the 21st century in which the full power of information technology, social media, artificial intelligence is being applied to almost every aspect of this response, both in terms of risk communication with communities and targeting information and avoiding misinformation and conquering misinformation. And that’s probably been one of the most powerful uses of information technology in this response.

Michael J. Ryan: (31:09)
And we thank all of those agencies, both public and private, who have joined with us and with our partners to really enhance the way in which we can communicate the best information to people. Beyond that, there are a huge number of collaborations around surveillance applications, modeling and predictive modeling, analytics in decision support tools and many of these other applications. And Korea, China itself, and other countries have developed apps that have supported them in case detection, case reporting, case followup, tracking, tracing and many other things.

Michael J. Ryan: (31:51)
And we ourselves have deployed our Go Data platform, which is a platform for contact tracing and followup and linking to lab results to over 50 countries now. And there are other IT applications like epidemic intelligence from open sources, which we use. We built that over the last five years with a consortium of international partners, which tracks electronic information in multiple languages from all over the world using AI engines and it allows us to stay one step ahead in terms of information around the virus and other epidemics around the world.

Michael J. Ryan: (32:26)
We are working with the ITU, our Chief Information Officer, Bernardo Mariano, is coordinating a huge partnership across the world with many institutions including the ITU to develop the best possible solutions. There is a tremendous amount of innovation and a huge amount of enthusiasm, but we need to turn that innovation and enthusiasm in a really structured way into products that work for frontline workers, that work for frontline systems.

Michael J. Ryan: (32:51)
And that’s what we’re in the process of doing now. We do always have to have in the back of our minds, especially when it comes to collecting information on individual citizens or tracking their whereabouts or movements that there are always very serious data protection, human rights and principles that are involved. And we’re very, very cognizant of that. And we want to ensure that all products that are developed are done in the most sensitive way possible and that we never step beyond the principles of individual freedoms rights for individuals and for society.

Michael J. Ryan: (33:33)
But yes, there are tremendous amount of collaborations ongoing. I could probably speak about this for a lot, lot longer and maybe Maria might want to speak about the modeling work and predictive analytics and other work that we’re doing specifically. But again, I would just like to thank our partners from all over the world. The power of innovation, the power of ideas, and we’ve had ideas for apps from people as young as 14 or 15, from individuals, from small startup companies, from huge globally based companies. It’s been the most outstanding and most amazing outpouring of support and collaboration that I have seen in my career.

Dr. Maria Van Kerkhove: (34:17)
Yeah. Just to add a couple of things where what we’ve seen particularly in this pandemic, but we’ve seen in other epidemics, the use of telemedicine. So many people who need care, who can’t go to hospitals right now or can’t go to their regular routine appointments are utilizing telemedicine. And having interactive chats and conversations with their doctors so that they continue to have care from the comfort of their home without having to go into a healthcare facility. And we’re seeing the application of that across many different types of medicine.

Dr. Maria Van Kerkhove: (34:47)
We’re seeing innovative ways in which children and university students can continue their education. Even though we have a large number of children and young adults who are out of school right now because of this pandemic. There’s interactive ways in which they’re continuing their education and learning through this pandemic even if they’re not physically in school. We see interactive ways in which technology is helping us do trainings where we can’t do face-to-face trainings because we’re not able to move around the globe. We’re finding ways in which we can provide these materials either online, through our open WHO platform, where we have more than half a million people up to 600,000 people who’ve enrolled in our courses in more than two dozen languages.

Dr. Maria Van Kerkhove: (35:33)
But we’re also using technology to find more interactive ways to have one-on-one conversations with those frontline workers to answer and work through some of those very difficult questions that they may be having as they treat patients or care for patients or set up a treatment units, et cetera. And we’re also using technology in many different ways for these predictive analytics that Mike has mentioned. We work with a large number of modelers, you’ve heard me say this before, to work through scenarios, to work through predictions, but of course these predictions are not realities.

Dr. Maria Van Kerkhove: (36:05)
And so what is important is that we take all of these measures that we’ve been outlining from the start, to make sure those predictions do not become realities. And lastly, technology and IT and apps have completely changed the way we think of social distancing. We’re saying physical distancing now because we’re actually talking about separating physically people, but keeping them socially connected. And we have ways in which we can do this now like we’ve never had before. So we keep people connected so that they feel that they’re still part of this and we’re all in this fight together even while keeping them physically apart.

Margaret: (36:45)
Thank you very much, Dr. Van Kerkhove. The next question is from Ankit Kumar from India Today, but before Ankit comes on I’d like to remind everybody to use the raise your hand icon and to apologize for saying hash nine, it’s star nine on your keypad for your telephone. Ankit, are you there? Can you go ahead with your question?

Ankit Kumar: (37:09)
Thank you, Margaret. Good evening, everyone. My name is Ankit Kumar. I represent India Today and Aaj Tak. In India, there is three weeks long lockdown, which means 1.2 billion people are currently inside their homes right now. But, we keep hearing about the possible second and a third possible wave of outbreak in near future. A country like India cannot afford many such lock downs after this one ends. What is WHO’s best advice to Indian policy makers, what they must do during this lockdown to ensure that there isn’t an outbreak and such a lockdown again in near future? Also, if you could please tell us how far are we from a possible vaccine or a medicine? Thank you very much.

Michael J. Ryan: (37:55)
Thank you, Mr. Kumar. Your question is a very good one. And I think the Director General-

Michael J. Ryan: (38:02)
… a very good one, and I think the Director General answered that question very much in his address. He mentioned the six things that every country needs to do to use this window of opportunity. As I’ve said in previous press conferences, India has incredible capacities to leverage, accelerate, and expand its capacity, but it must do the things. You must have a system to find cases, you must test, you must expand your capacity to treat and isolate, you must be able to quarantine your contacts, and you must bring an all of government approach to the response.

Michael J. Ryan: (38:44)
If those things are put in place, and I know they are being put in place, but we can accelerate that, and India is a vast country. You could never look at India just as one single entity from an epidemiologic perspective, and if you remember those of you who in India who were involved in the process, India got rid of polio by breaking it right down. India got rid of polio by breaking it down to the village level all the way through the system. It broke down the problem. It went after the polio virus district by district, by district, by district, and India won.

Michael J. Ryan: (39:20)
If India does the same thing, breaks down the problem, puts in place the measures that are needed, both surveillance and healthcare measures, and does that systematically, then there is a way out, there is a transition from lockdowns into a public health driven response in which people don’t have to stay locked in their homes for more time than is absolutely necessary. Without implementing the necessary measures and without putting in place those protections, it’s going to be very difficult for countries to exit, and when they do, they may have resurgence. I think that’s the challenge now. We have time, very little, as the Director General said, a second, but small window opportunity. What countries do today, tomorrow, the next day is what’s going to matter.

Dr. Maria Van Kerkhove: (40:09)
If I could add to that, we have seen countries that have gone through these so-called lockdowns, have gone through these public health measures and distancing measures, and we need to learn from all of these countries who have applied these measures at different levels of intensity. We know what measures were taken in China and, in particular, in Wuhan and in Hubei. We know that these measures are being lifted now, and the reason that they can be lifted is because these systems are in place to actually quickly identify and isolate any cases that pop up.

Dr. Maria Van Kerkhove: (40:43)
Now, what we’re seeing in China is we’re not seeing indigenous cases, cases that are being locally transmitted. We’re seeing new importations. There are more importations that are going into China than are actually being detected from local transmission. We haven’t had local transmission, I think, in a number of days now, but what my point is bringing up China is saying they have looked at a staggering approach of lifting these measures. It wasn’t all at once across the whole country. In different parts of the country, they applied different intensities of levels of these measures, so it wasn’t a total lockdown in all places across China. We know in Singapore, they used a different approach. They did have some application of social distancing or physical distancing measures, but they didn’t close their schools. It’s really important for us to take the examples of all of these countries and look in detail about what they did as it relates to the epidemiology in their country and learn from them, and we are doing that now. We are taking very detailed looks at what every country is doing, what countries have done, and the levels of success that they have had. Again, we can come back and say, “These are the things that really have worked.” We know the things that we’re telling you, these are the things that work.

Dr. Maria Van Kerkhove: (41:57)
We know that they’re incredibly difficult, but what we don’t want is to get into a situation where you have a lockdown, then you lift it, then you have a resurgence, and then you have a lockdown, and you have this endless cycle. We need to break that cycle so that these measures that are put in place are temporary. We know that these are incredibly difficult, and we thank you for playing your individual part in this outbreak, but we know that these things work. They are temporary. We will get through this, but those measures to find those cases, isolate those cases, find and quarantine your contacts, treating patients who require treatment is really, really critical.

Dr. Tedros Adhanom: (42:38)
I think, for India, with 606 cases, I have already outlined the six steps. Doing that now will help India to stop from the virus spreading to more places or getting bigger. As Mike said, India has the capacity, and it’s very important and good to see that India is taking early measures, and this will help you to suppress and control it as soon as possible before it gets serious. It’s very important. What’s happening now, India, which [inaudible 00:43:32] to cut it from the bud when you only have 606 cases only.

Margaret: (43:44)
Thank you, Dr. Tedros. We now have Camilla from the Financial Times, a question from Camilla. Camilla, are you on the line?

Camilla: (43:54)
Hi, yes, can you hear me?

Margaret: (43:56)
Yes. Please go ahead.

Camilla: (43:58)
Thanks for taking my question. The DG has talked before about possible risks to essential medical supply chains. Are there any specific products or regions or parts of the supply chain that are under particular strain at the moment?

Michael J. Ryan: (44:17)
Hi there. Yeah, I think you’d have to say that all elements of the supply chain for many, many different products are under extreme strain at the moment. That’s from raw materials through to production, distribution, and delivery, and there are different reasons driving some of that. Production, in some cases, for example, a lot of the rubber that’s used to produce rubber gloves is produced in a very small number of countries. If those countries have difficulties in their general supply chain or have a problem of pushing things into the international market, then the place that makes the gloves may have a difficulty in actually making the gloves, not because they lack the production capacity, but they lack the raw material. There are problems in the supply chain all along that chain.

Michael J. Ryan: (45:09)
The simple issue is demand because our current production of protective equipment, of ventilators, was obviously pretty adequate to meet global demand before this event began, but, unfortunately, the world is not ready for a pandemic, and in not being ready, we don’t have the security stockpiles in place that are immediately deployable in order to scale up our capacity to protect our frontline health workers and others.

Michael J. Ryan: (45:39)
There are shortages of PPE, shortages of ventilators, and other products that are for the medical response to COVID. We also have to avoid shortages in other medical supplies as supply chains come under strain, and that may be because of secondary effects of the virus, which is the shutting down of air corridors, cancellation of flights all around the world. Many of passenger flights around the world also carry cargo. Difficulties in shipping and even cargo shipping with crews are finding that the … Some shipping agents are finding it hard to move materials around the world. There’s strain on the whole system.

Michael J. Ryan: (46:21)
We’re working very, very closely. The Director General is, and even after the launch of the humanitarian appeal had a further very fruitful discussions with the secretary general on dealing with this issue and the huge commitment of the UN system to do everything possible together under Director General’s leadership to improve, scale up, and deliver to the extent possible the essential supplies that health workers and frontline workers need around the world in terms of PPE, ventilators, and other supplies, and there’s been a huge scaling up of that capacity, and we will make further announcements in the coming days of further scale-ups in that capacity to deliver, but what we also need is a ramp up in production and a ramp up in funding for that material. I believe the Director General, he may speak to this, we’ll be raising this issue very much at the G20 Leaders meeting tomorrow.

Dr. Maria Van Kerkhove: (47:29)
If I could just add that Mike has outlined what we’re doing to address this problem and how we’re working with so many different partners, but we need to be clear. The world is facing a significant shortage of PPE for our frontline workers, including masks and gloves and gowns and face shields, and protecting our healthcare workers must be the top priority for the use of this PPE. We’re working with technical partners across the globe to identify ways in which we can manage this current shortage while we try to find solutions, but some of these options are not ideal and this is not acceptable. We have to all play our part to make sure that we prioritize the use of PPE, we use PPE appropriately, and that is for our frontline workers who are caring for patients.

Margaret: (48:22)
Thank you very much, Dr. Van Kerkhove. We now have a question from Verah [Okeyongo 00:10:27]. My apologies, Verah, if I’ve got your name wrong, from Nation Media Africa. Verah, are you on the line?

Verah Okeyongo: (48:37)
Yes, I’m on the line. Can you hear me?

Margaret: (48:39)
Yes, very well. Please go ahead.

Verah Okeyongo: (48:42)
All right. I’m just going to rush through it. I would like to know in the modeling that you guys have done and have talked about [inaudible 00:10:49], is there any indication of how this thing may affect African countries? Just quickly, on top of that, we have the Africa CDC, and I would like to, a comment from the Director General how they plan to support it. It was being funded by the AU, but the last time I talked to the Deputy Director, money seems to be drying up there, and the work that they’re doing now is very critical given the health systems that we have in Africa are very fragile. Thank you.

Michael J. Ryan: (49:23)
You start. You start. [crosstalk 00:49:30]-

Dr. Maria Van Kerkhove: (49:30)
I can start in, and Mike will supplement. I can start on the first part of that with the questions about the use of mathematical models to look at what may happen. We are working with a number of groups that are looking at these types of scenarios in terms of using available epidemiologic information about how this virus is transmitted, the rate in which it has moved through populations in China and Italy and in other locations, to use those parameters, as we call them, to estimate what may happen in a new population and in Africa, for example, and in using that information, you can estimate what case numbers and deaths may look like if we don’t do anything, if we don’t have any interventions, and some of those numbers are very high, some of those numbers are quite scary, but what those models can also do is they can also look at what may happen as you implement certain interventions, and these are the interventions that we have outlined, which are public health measures, which are physical distancing measures, which are making sure that you have testing capacity improved and finding all of your cases.

Dr. Maria Van Kerkhove: (50:42)
When you look at those scenarios, those case numbers reduce. That’s what is important in those models. They also help us plan. They also help us estimate case numbers based on what level of severity they may have, if they may have mild infection, moderate infection, maybe severe and require oxygen, may need ventilatory support to respiratory support. Those models help us estimate what kind of supplies we need, and we’re using those right now to estimate what we would need to supply for countries. They’ve been very helpful. We can look at the country level. We could look at regional levels. We’re working with modeling partners to create tools that countries can use to help prepare.

Michael J. Ryan: (51:28)
Just on the Africa CDC, actually, the Director General and I spoke with John and [Kanga Zhan 00:00:51:36]. John is the Director of Africa CDC and, in fact, has taken on a role as a special envoy of the Director General and for our COVID-19. Africa CDC is a very important institution in Africa. WHO supported its creation. Director General was one of its founding members before he took his role as Director General, and Dr Tshidi Moeti, our Director for the Regional Office for Africa, and John work very closely together to ensure that the member states and countries in Africa get the best possible public health and health advice, inputs and support from both our organizations.

Michael J. Ryan: (52:18)
We’ve worked together with the Africa CDC on training lab technicians in COVID-19 diagnosis from all over Africa. We’ve worked together on the distribution of laboratory tests, and we’re currently working together with colleagues in China on the procurement and distribution of PPE across Africa. I would characterize very strong operational, growing technical and operational relationship with our colleagues in the Africa CDC, and, obviously, in future, the WHO in itself is not a funding organization. We will always be advocating for the funding and support to strong African institutions to provide support all across the continent, and I’m sure, through this response, one of the benefits, if there is anything to be seen in benefit at the moment, is we need to build stronger public health systems at sub-national, at national, and at global level. If any lesson is to be learned from the current pandemic is that we need stronger public health systems, and we will work very hard with our Regional Office for Africa, with John at Africa CDC under the leadership of the Director General to deliver stronger public health and health systems on the African continent in the coming years.

Margaret: (53:40)
Thank you very much, Dr. Ryan. The next question is from Deguchi from Kyodo. We’ve only got time for two more questions, so I’d ask very much that you keep your question as short as possible. Deguchi, are you there?

Tomohiro Deguchi: (53:56)
You can hear me?

Margaret: (53:57)
Yes, we can.

Tomohiro Deguchi: (53:58)
Hello?

Margaret: (53:58)
Please go ahead.

Tomohiro Deguchi: (54:00)
Hi, this is Tomohiro Deguchi with Kyodo, Japanese news agency. A question to Dr. Ryan on the Tokyo Olympic games. What was the advice that WHO have given to International Olympic Committee and Japanese government before they made the decision? Thank you.

Michael J. Ryan: (54:17)
[inaudible 00:54:21]. Oh, right, thank you for your question. We’ve been working over many years with the International Olympic movement in providing them with risk management advice for many, many of their events going back to Rio and previously, and we do not take any final decisions when it comes to the staging events or not, but we advise organizing groups and FIFA and IOC and people organizing huge events, like the [inaudible 00:54:55] in the kingdom of Saudi Arabia, on how risks, biologic risks, can be managed, how they can be identified, how they can be minimized, and how any residual risk can be managed so that games can be carried out successfully, and mass gatherings can go on without access risk to public health, both in the country of the gathering or subsequently after in other countries.

Michael J. Ryan: (55:16)
In the same regard, we’ve had many conversations with our colleagues in IOC and with the Tokyo 2020 Committee and the Japanese government over the last two months in advance of their decision yesterday, and we continued to provide them up to yesterday with advice under developing an escalating pandemic, the likely situation that may pertain later in June and July and not withstanding the excellent efforts of Japan in containing the disease.

Michael J. Ryan: (55:48)
There are other factors that had to be taken into consideration, which would include potentially the situation in many other countries that might pertain at that time the difficulty of movement and the risk that might be associated with disease arriving in and potentially subsequently moving from Japan to other areas. Many, many issues were put on the table. We stick to our job, which is to provide public health risk assessment and public health advice. The decision to postpone the Olympics was made wholly and solely by the IOC and by the Japanese government, but as the Director General said in his statement, we fully support that decision.

Margaret: (56:31)
[inaudible 00:56:31] that Dr. Ryan said. Two of the people who were in the queue have put their hands down, but we have a question from Associated Press. Please go ahead.

Margaret: (56:48)
It looks like we don’t have that question from Associated.

Jamie: (56:50)
Can you hear me?

Margaret: (56:51)
Oh, there you are. Please go ahead.

Jamie: (56:53)
Hi, this is Jamie from AP. Just wanted to ask you very quickly, Dr. Tedros, about the tw-

Jamie: (57:03)
Dr. Tedros, about the tweeting that you did yesterday, you were pretty praiseworthy of President Trump’s efforts. And I’m just wondering, you said he’s doing a great job. And I’m just wondering, that President Trump has from the beginning, sort of minimized the importance of this at the very start. And then is now talking about churches that might be packed in the United States come Easter time. How concerned are you about some of the decisions that he’s making? Do you really think he’s doing a great job across the board? Thanks.

Dr. Tedros Adhanom: (57:45)
Yeah, I stand by what I said. As you know, one of the recommendations from WHO is the whole of government approach, involving all sectors. And the principal, which is the head of state, taking responsibility and leading the whole response. And that’s exactly what he’s doing and which we appreciate, because fighting this pandemic needs political commitment and commitment at the highest level possible. And the President’s commitment, you have already seen it, and the world have seen it. And that kind of leadership is very, very important, the whole of government approach to mobilize all sectors and stop or suppress the pandemic.

Dr. Tedros Adhanom: (58:47)
So I know he’s doing all he can. But not only the whole of government approach, but the other, expanding testing and also the other recommendations we’re making are also in play. And he takes that seriously, and that’s what we see. And I had a conversation, I had a chance to discuss with him and that’s what he said and is doing. So, I believe that that kind of political commitment and political leadership, can bring change or can stop this pandemic.

Michael J. Ryan: (59:34)
I would just supplement. Again, just to say earlier today we spoke with Bob Redfield and Tony Fauci. and we’re very impressed to see the work that their institutions and other institutions, technical, fabulous public health research and other institutions are doing in the United States. But also supporting on the international front. We’ve had the benefit of having had [inaudible 01:00:04] from CDC Atlanta present here in Geneva for more than a year and a half now between Ebola and between COVID-19. Our colleagues at NIH are the ones who have innovated and have managed working with others in the United States to start the first trials of vaccine. NIH and ourselves are working very closely together on trials of existing therapeutics. The FDA have been exceptionally helpful on the regulatory side and are working with us on everything from animal models for vaccine development and much, much more.

Michael J. Ryan: (01:00:37)
We rely heavily on the scientific innovation and public health prowess of the United States and very much appreciate the way in which Dr. Fauci broke down the issue yesterday when he spoke about the data. And he spoke about getting down to the state and the county level, and working through the problem, and working through the issues. And again, we remain impressed by the work being done at state level, by state and county public health departments. Now is the time to support them. Now is the time that health workers all over the world, need to get the support to do the jobs they need to do. They are heroes and we’re all there to support them.

Margaret: (01:01:19)
Thank you very much, Dr. Ryan. And on that inspiring note, we’ll close this press conference. Thank you very much everybody for attending. We will send the audio, we will send the transcript as usual. We’ll also send you information about the WHO Film Festival. Thank you again, and we’ll reconvene on Friday.

Dr. Tedros Adhanom: (01:01:41)
Thank you. Thank you and see you on Friday. (silence)